Metro Manila (CNN Philippines, May 4) – The Philippine Health Insurance Corporation (PhilHealth) said it owes ₱7 billion to some 5,000 hospitals, clinics, and other health facilities due to unreturned claims.
PhilHealth President and CEO Ricardo Morales clarified, however, that it is normal for a large corporation like the state insurer to have accounts payable or debts with some hospitals.
“We have always accounts payable at any time. Because we are a large corporation, we transact about 1 million claims a month, we pay out between ₱10 to ₱12 billion a month,” he told CNN Philippines’ News Night.
Morales explained that the amount they owe with some hospitals is called a Return to Hospital claim, which is a claim redirected back to the health facility due to deficiency in documents or requirements.
“Because sometimes the claims is [sic] not complete, may hindi compliant sa requirement (some are not compliant with the requirement), so we return this to the hospital. At the end of 2019, this accounted to ₱12 billion for the 5,000 or more hospitals, clinics,” he said. “As of latest count, we have reduced it to ₱7 billion. So nababayaran namin ‘yan (So we are able to pay them).”
Morales said PhilHealth is trying to adapt to a computerized mode of transaction with hospitals to avoid fraud and faster release of payment.
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